Bicycle-Related Injuries: Data from the National Electronic
Injury Surveillance System

Since its inception in 1972, the U.S. Consumer Product Safety
Commission (CPSC) has used its National Electronic Injury
Surveillance
System (NEISS) to collect data on product-related injuries treated
in
emergency rooms. Currently, 62 hospitals located throughout the
United States contribute to this data base. Based on NEISS data,
CPSC
estimates that in 1985 there were nearly 10 million emergency room
visits for nonoccupational, product-related injuries.
Approximately
574,000 (5.7%) of these involved bicycles.

To determine whether NEISS could be expanded to cover all
reported
injuries, CPSC conducted a special study supported by CDC and the
Bureau of Justice Statistics of the U.S. Department of Justice.
From
September 15-28, 1986, eight of the reporting hospitals collected
data
on all injured patients, whether or not consumer products were
involved.

Information collected on the 3,418 injuries reported during the
study period included a narrative description of all injury events.
For each of the 2,232 product-related injuries, the product
involved
was assigned the corresponding NEISS consumer product code. The
narrative descriptions were reviewed, and each injury was assigned
an
external cause of injury code (E-code*) in accordance with the
International Classification of Diseases, Ninth Revision, Clinical
Modification (1). The 120 incidents that involved noninjury
conditions were excluded from further analysis.

To assess the value of the data collected during this broad,
short-term study, bicycle-related injuries were analyzed. During
the
2-week study period, bicycle-related injuries accounted for
slightly
more than 3% of the 3,298 injuries treated. Five of the 101
patients
with bicycle-related injuries were hospitalized, and the remaining
96
were treated and released. There were no deaths due to
bicycle-related injuries.

As in other investigations, 15% of the bicycle-related injuries
resulted from collisions with motor vehicles (2,3). Sixty-nine
bicyclists were injured while riding in locations other than public
highways. Seventeen injuries involved bicycles being maintained or
otherwise not being ridden. Compared with nonbicycle-related
injuries, bicycle-related injuries were more likely to involve
facial
trauma but less likely to involve other head trauma (Table 3).
Bicycle-related injuries accounted for approximately the same
proportion of total trauma visits for both sexes (Table 4).
However,
there was large variation across age strata; more than half of the
bicycle-related injuries occurred in the 5- to 14-year-old age
group.
Reported by: Div of Injury Epidemiology and Control, Center for
Environmental Health, CDC.

Editorial Note

Editorial Note: Analysis of the NEISS data generated in this
special
2-week study has led to several observations about the system.
First,
NEISS has the potential for monitoring a variety of injuries
including
those that are of public health concern. Second, the system can be
temporarily expanded on short notice. Third, a succinct narrative
description of the circumstances of injuries allows E-codes to be
assigned in most instances. Finally, E-coding in areas such as
bicycle-related injuries can be effectively supplemented by NEISS
product codes (19 of the injuries were identified and two erroneous
ones were excluded on the basis of the product code).

In the special NEISS study reported here, bicycle-related
injuries
accounted for slightly more than 3% of the 3,298 injuries treated.
The difference between this percentage and the 1985 CPSC national
average of 5.7% is, for the most part, attributable to the
inclusion
of occupational and nonproduct-related injuries in the special
study.
These inclusions increased the denominator by almost 33% while
adding
no additional bicycle-related injuries to the numerator. In
addition,
the study was carried out during a time when the rate of
bicycle-related injuries is lower than the yearly average.

The number of injuries reported during this study did not
provide
sufficient data to completely evaluate the range of seriousness of
bicycle-related injuries. In this short time period, there were no
deaths and only 5 of the 101 patients with bicycle-related injuries
required overnight hospitalization. Other investigations have
shown
that the most serious bicycle-related injuries involve head trauma
resulting from crashes with automobiles (4,5).

Measures to prevent bicycle-related injuries can be categorized
under 1) proper road design and maintenance, 2) improvement in
bicycle
manufacture, and 3) dissemination of safety information (2). The
need
for improvements in the manufacturing of bicycles was identified
through analysis of NEISS data. In response to this need, CPSC
issued
safety standards in 1974 for bicycle frames, brakes, steering
systems,
and wheels and required a standardized road test for bicycles (6).
Dissemination of safety information includes education regarding
safe
riding practices, bicycle maintenance, and use of appropriate head
gear (7). Sample copies of bicycle safety information for children
are available to health professionals from the American Academy of
Pediatrics, Publications, 141 Northwest Point Blvd., Elk Grove
Village, IL 60009-0927.

References

Commission on Professional and Hospital Activities. Annotated
international classification of diseases, ninth revision,
clinical
modification. Ann Arbor: Commission on Professional and
Hospital
Activities, 1986.

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